Smardova L, Engert A, Haverkamp H, Raemakers Jm, Baars Jw, Pfistner B, Diehl V, Josting A
Internal Department of Hematooncology, University Hospital Brno, Brno, Czech Republic.
Leuk Lymphoma. 2005 Jul;46(7):1017-22. doi: 10.1080/10428190500064276.
High-dose chemotherapy followed by autologous stem cell transplantation can improve the outcome of relapsed and refractory Hodgkin's disease (HD) patients. The objective of the trial was to determine the mobilizing potential of the DHAP salvage regimen (dexamethasone, cytarabine, cisplatin) for the collection of peripheral blood stem cells (PBSC) in patients with relapsed HD. The target yield of harvesting CD34 + cells was > or =2 x 10(6)/kg in order to support the subsequent myeloablative chemotherapy. Most of the 105 patients included were intensively pre-treated with different combination chemotherapy regimens prior to mobilization. The use of DHAP followed by granulocyte colony-stimulating factor (G-CSF; 10 microg/kg) resulted in the successful collection of adequate numbers of PBSC in 97.1% of patients (102 of 105) with a median harvest of CD34+ cells of 13 x 10(6)/kg (range 2.6 - 85.1). More than 2.0 x 10(6) CD34+ cells/kg were achieved in 65 of 103 (63%) patients after 1 apheresis, the maximum number of aphereses for all patients was 3. It was found that the optimal time of PBSC harvest was at days 13 - 16 after initiating the mobilization regimen. These results demonstrate that the salvage chemotherapy regimen, such as DHAP combined with G-CSF, can be successfully used to mobilize PBSC in HD patients.
大剂量化疗后进行自体干细胞移植可改善复发难治性霍奇金淋巴瘤（HD）患者的预后。该试验的目的是确定DHAP挽救方案（地塞米松、阿糖胞苷、顺铂）对复发HD患者外周血干细胞（PBSC）采集的动员潜力。为支持后续的清髓性化疗，采集CD34 +细胞的目标产量为≥2×10⁶/kg。纳入的105例患者中，大多数在动员前接受了不同联合化疗方案的强化预处理。使用DHAP后联合粒细胞集落刺激因子（G-CSF；10μg/kg），97.1%的患者（105例中的102例）成功采集到足够数量的PBSC，CD34 +细胞的中位采集量为13×10⁶/kg（范围2.6 - 85.1）。103例患者中的65例（63%）在1次单采后获得了超过2.0×10⁶ CD34 +细胞/kg，所有患者的最大单采次数为3次。发现PBSC采集的最佳时间是在启动动员方案后的第13 - 16天。这些结果表明，诸如DHAP联合G-CSF的挽救化疗方案可成功用于动员HD患者的PBSC。
